The fluid and toxin buildup in the body cause the signs that your kidneys are not effectively working. The most obvious sign is decreased urine output, although this isn’t always the case. Some people continue to produce urine, but lab tests will show that the urine is not normal.

Someone with acute kidney injury usually also looks swollen as the fluid accumulates in the body’s tissues. This swelling is called edema and can come on very quickly.

Other symptoms of acute kidney failure can include:

• Shortness of breath
• Confusion
• Fatigue
• Nausea
• Seizures
• Coma

Urine and blood tests tell doctors how well your kidneys are functioning, so many samples are taken during diagnosis and treatment. For example, the doctors test for creatinine, which is created when muscle begins to break down. A BUN test (blood urea nitrogen) tells you if a substance called urea is building up in the blood. This is an indicator that the kidneys are not filtering waste properly.

When someone has sepsis or is in septic shock, the doctors work to treat the sepsis, the infection that caused the sepsis, and the damage that the sepsis has done, such as the kidney failure.

If the kidneys are not working efficiently enough to filter toxins and allow urine to flow, an artificial way of filtering the kidneys, dialysis, can take over. Dialysis is not a cure though. Instead, it gives the doctors a way to clean the blood while trying to control everything else.

There are two types of dialysis, hemodialysis, and peritoneal dialysis. Peritoneal dialysis is generally used to manage chronic kidney failure. But it can be used for acute kidney failure where hemodialysis isn’t possible in areas with limited resources. For example, peritoneal dialysis has been used in Africa for patients who have malaria-associated acute kidney injury.

With hemodialysis, a machine called a hemodialyzer is the artificial kidney. A catheter (tube) placed into the patient’s vein leads to the other end of the catheter in the hemodialyzer. When the process starts, blood flows a few ounces at a time from the patient’s body to the machine. The machine filters it and sends the blood back through the catheter to the body.

People who receive dialysis are at risk of infection at the catheter site since the catheter is an invasive device. Therefore, it’s essential that they monitor the site for any signs of infection, like redness, swelling, skin warmer to touch, and fever.

How often and how long each procedure takes depends on how much kidney function still exists, patient size, and how much toxins have accumulated in the blood since the previous treatment. Dialysis can be intermittent (for three or four hours every or every other day) or continuous but at a slower rate.

In acute kidney failure, dialysis is usually a temporary measure as the doctors work to fix the problem that caused the kidney failure. If the kidneys begin to work properly again, even if not at 100 percent, dialysis can usually stop.

Some people need to continue receiving dialysis treatments if the kidney damage is too severe and permanent. Since dialysis is not a cure, they may be candidates for a kidney transplant if they qualify.

Some sepsis survivors continue to have problems with their kidneys, despite recovering from the sepsis itself. Doctors monitor their patients’ kidney function through regular check-ups and blood tests if there is lasting kidney damage.